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Non-uraemic calciphylaxis (NUC) postliver transplantation
Simona Frunza-Stefan1, Silpa Poola-Kella2, Kristi Silver1
1Medicine; Endocrinology, Diabetes and Nutrition, University of Maryland Medical Center, Baltimore, Maryland, USA.
BMJ Case Reports
|October 27, 2018
Summary
Non-uraemic calciphylaxis (NUC) is a rare condition causing skin necrosis. This case highlights NUC in a post-liver transplant patient, emphasizing its consideration in differential diagnoses for necrotic skin lesions.
Area of Science:
- Dermatology
- Nephrology
- Transplantation
Background:
- Calciphylaxis is a rare, life-threatening condition causing skin ischemia and necrosis.
- It predominantly affects end-stage renal disease patients but can occur in those with normal renal function (non-uraemic calciphylaxis - NUC).
- NUC is a critical differential diagnosis for necrotic skin lesions, particularly in specific patient populations.
Observation:
- A 41-year-old African-American woman developed painful, ulcerative skin lesions on her thighs and buttock two months post-liver transplant.
- The patient had received high-dose glucocorticoids but lacked other typical calciphylaxis risk factors.
- Skin biopsy confirmed calciphylaxis.
Findings:
- The patient was treated with sodium thiosulfate, cinacalcet, and hyperbaric oxygen.
- Complete resolution of the necrotic skin lesions was achieved within 4-5 months.
- This case demonstrates successful treatment of NUC in a post-liver transplant setting.
Implications:
- Non-uraemic calciphylaxis (NUC) should be included in the differential diagnosis for necrotic skin lesions in liver transplant patients.
- Early recognition and multimodal treatment can lead to complete resolution of NUC.
- Further research into NUC pathogenesis and risk factors in transplant populations is warranted.
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